Yellow Fever (cont.)

Steven Doerr, MD

Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

What is the prognosis for people with yellow fever?

The prognosis for individuals who develop uncomplicated yellow fever is generally excellent. However, for those patients who go on to develop the toxic phase of yellow fever, case-fatality rates range from 15% to more than 50%. If death occurs, it is typically within 10-14 days after the onset of the toxic phase. Infants and those older than 50 years of age tend to have more severe disease and higher mortality rates. Furthermore, host susceptibility and the virulence of the particular infecting strain can also influence mortality rates. In those individuals who survive yellow fever, generally there is no residual permanent organ damage.

Can yellow fever be prevented?

Vaccination remains the most effective way of preventing yellow fever. The yellow fever vaccine has been used for several decades, and it is a safe vaccine with only rare serious adverse events reported. It is a live virus vaccine that provides immunity for 10 years (and longer) after a single dose. It provides immunity against yellow fever in 95% of individuals within one week of its administration. A booster dose is recommended every 10 years for those individuals at risk for continued yellow fever exposure. The vaccine is available for adults and children older than 9 months of age. It is recommended for travelers to areas where yellow fever is endemic and to local populations who are at risk. Several countries require travelers to demonstrate proof of yellow fever vaccination status for entry in order to prevent the importation and transmission of yellow fever. Check with your local health department for information regarding designated yellow fever vaccination centers.

Effective mosquito-control measures are also an important component for preventing or minimizing the risk of yellow fever. Avoiding mosquito bites by wearing protective clothing (long sleeves and long pants) and remaining in properly screened or air-conditioned accommodations is recommended. Furthermore, applying insect repellant containing DEET or Picaridin on exposed skin is advised.